Systematic Review Methods

The review is described as the first systematic review to synthesize both quantitative and qualitative evidence specifically on interventions to improve FIT returns using a mixed-methods approach. The primary outcome is delayed care-seeking from symptom onset or recognition to first contact with a healthcare professional or facility. Eligible participants are adults with physician-diagnosed COPD who have experienced at least one AECOPD. Eligible study designs include prospective cohort, retrospective cohort, case-control, and cross-sectional observational analytic studies. All eligible studies will be included in the synthesis regardless of quality. The review used systematic review procedures based on the Cochrane handbook and PRISMA 2020 reporting. The synthesis included seven peer-reviewed qualitative studies with 593 total participants. Thematic synthesis proceeded through line-by-line coding, grouping into 23 subthemes, and development of five analytical themes in three broader categories. Two reviewers independently screen titles, abstracts, and full texts, with disagreements resolved by a third reviewer. Searches will cover databases from inception to January 2025 without l…